RESUMEN
Adventure Therapy (AT) is a therapeutic intervention utilizing the natural environment and adventure activities as tools for psychotherapeutic interventions. It has been demonstrated to be appropriate for the intervention of patients with borderline personality disorder (BPD). This study aims to evaluate the response to AT treatment compared with the response to treatment as usual (TAU), based on cognitive behavioural therapy, in the short and long term, assessing clinical, psychosocial, and functional outcomes; quality of life; and physical health levels. This study extends the sample of and is a follow-up to a pilot study published in 2021, with a sample of 30 patients in the AT group and 10 in the control group. It does not allow us to affirm that AT provides better outcomes than TAU, as the positive effects observed immediately after therapy seem to be attenuated in the long term. Therefore, the effectiveness of long-term psychotherapy did not show differences between AT and TAU therapies in the treatment of BPD patients. However, the effects of intangibles observed during therapy by professionals and patients were not reflected in the measurements collected. Therefore, we believe it is necessary to increase the programme duration, complement treatment with a specific physical health programme, assess results with more specific instruments, and/or move towards a qualitative methodology to measure perceived changes in clinical improvement. New studies are needed to evaluate the results of the proposed changes.
RESUMEN
The behavioural variant of Frontotemporal Dementia (bvFTD) is a neurodegenerative condition characterized by behavioural and cognitive symptoms. Mood disturbances, including manic-like episodes, can occur in bvFTD, posing diagnostic and therapeutic challenges. This case report presents a 62-year-old male with bvFTD exhibiting weekly mood fluctuations alternating between manic and depressive-like states. While initial treatment with quetiapine and trazodone showed partial improvement, the periodicity of mood fluctuations persisted. Subsequently, lithium was introduced, resulting in a notable reduction in symptom severity for both manic and depressive episodes. This report highlights the potential use of lithium as a mood stabilizer in bvFTD patients with periodic mood fluctuations, refractory to standard treatments. Further research is needed to elucidate the mechanisms underlying lithium's efficacy in bvFTD and to establish treatment guidelines.
RESUMEN
Introduction: The COVID-19 pandemic has forced changes in patient care in Mental Health Day Hospitals (MHDHs). Objectives: To study the interventions performed in MHDHs during the pandemic in comparison with those performed in other facilities and to analyze the new hospital admissions in both groups. Method: A retrospective multicenter cohort study comparing the interventions received by a group of 161 patients admitted in MHDHs during the lockdown period in Spain with the interventions of another group of 109 patients who were treated at other facilities during lockdown. Results: MHDHs reduced their face-to-face interventions during lockdown just as much as other facilities but implemented telematic intervention methods to a greater extent. Patients attached to MHDHs during lockdown were admitted significantly less and presented fewer urgent consultations in the following 6 months. Conclusion: The use of telepsychiatry made it feasible to adapt MHDHs to periods of lockdown, being useful to improve the continuity of care during the pandemic. In addition, it was possible to maintain a reduction in hospital admissions in patients treated at MHDHs.
RESUMEN
Adventure therapy (AT) is a therapeutic intervention that has demonstrated effectiveness in different populations, but there are no studies on this therapy in borderline personality disorder (BPD). The objective of this study was to assess the response to AT in comparison with treatment as usual (based on cognitive-behavioural therapy) in patients with BPD. Regarding the comparison of the differences post-therapy-pre-therapy between both groups, some metabolic variables improved more in the AT group, with medium-large effect sizes. Almost all psychometric variables evolved better in the AT group, with negligible effects. AT could be considered in BPD treatment because it results in healthier lifestyle habits and increases functionality and quality of life in patients who are prone to self-destruction. © 2021 John Wiley & Sons, Ltd.